Music medicine. A neurobiological approach

Music medicine is a relatively new medical specialty for most countries in the world and a rediscovery of a discipline for some countries in Europe. In the scope of music medicine are health problems of musicians like stage fright and psychic stress, pain syndromes and motor disturbances. Specific demands of musicianship like performing before the public, performing under the constant critical scrutiny of conductors, being expected to perform perfectly, and the physical demands of performing on a musical instrument were seen as the determinants of the complaints, and treatment does usually not differ between musicians and non-musicians with comparable diseases. In the present article, growing neurobiological evidence will be summarized showing that musicians differ from non-musicians on brain structure and function and on some hormonal and immunological parameters. Musicians tend to have atypical brain organization for verbal and non-verbal materials, their auditory system tracks sound levels more accurately, musicians attend pre-consciously to musical material and they react to music as if it is a stressor, i.e. with increased activity of the autonomic nervous system and with an increase in stress hormone production. A musician is more likely than a non-musician to be non-righthanded and to be vulnerable to atopic diseases. Testosterone levels are assumed to be lower (male) and higher (female) than controls. Melatonin was found to be elevated, and ACTH was related to musical talent. His/her brain reflects early music practice by enlarged structures, like the anterior part of the corpus callosum and the representation for piano tones and for the left thumb and little finger in string players. In addition, the left planum temporale was found to be larger in musicians with absolute pitch. These differences between musicians and non-musicians may have implications for music medicine in theory and practice, and further research should help to improve treatment of musicians.